脑电双频指数指导下监测麻醉在老年患者慢性硬膜下血肿手术中的应用

发布时间：2018-03-20 08:32

本文选题：脑电双频指数　切入点：监测麻醉　出处：《临床麻醉学杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的探讨脑电双频指数(bispectral index,BIS)指导下的监测麻醉(monitored anesthesia care,MAC)在老年患者慢性硬膜下血肿钻孔引流手术中的应用。方法选择2014年3月至2015年5月择期行慢性硬膜下血肿钻孔引流手术患者60例,男33例,女27例,年龄65~85岁,ASAⅡ~Ⅳ级,随机分为BIS指导下监测麻醉组(M组)和局部麻醉组(C组),每组30例。M组静脉应用丙泊酚和瑞芬太尼;C组仅采用局部麻醉,未给予任何静脉麻醉药,始终处于清醒状态。记录患者局麻药和血管活性药追加次数。采用Likert 7点量表法分别由患者和术者评估手术镇静/镇痛满意度。记录患者体动、恶心呕吐、反流误吸、呼吸抑制、呼吸道梗阻等不良反应发生情况。结果M组局麻药和艾司洛尔追加例数明显少于C组,镇静/镇痛满意度明显高于C组(P0.05)。M组体动发生率明显低于C组(P0.05)。两组呼吸抑制和呼吸道梗阻发生率差异无统计学意义,均未发生恶心呕吐和反流误吸。结论脑电双频指数作为反馈控制变量调控镇静麻醉技术可以达到较精确的控制麻醉深度,可安全用于老年患者慢性硬膜下血肿手术。
[Abstract]:Objective to investigate the application of bispectral index (bispectral index) under the guidance of bispectral index (BIS) in monitoring monitored anesthesia care in elderly patients with chronic subdural hematoma. Methods from March 2014 to May 2015, we selected a drill for chronic subdural hematoma in elderly patients. 60 patients underwent orifice drainage, There were 33 males and 27 females, aged from 65 to 85 years. They were randomly divided into two groups: group M (monitoring anesthesia under the guidance of BIS) and group C (group C under local anesthesia). Each group (30 cases) received propofol and remifentanil (group C) only by local anesthesia. Patients with local anesthetic and vasoactive drugs were recorded. Likert 7-point scale was used to evaluate the patients' satisfaction with sedation / analgesia. Adverse reactions such as nausea and vomiting, regurgitation, respiratory depression and respiratory obstruction occurred. Results the number of additional cases of local anesthetics and esmolol in group M was significantly lower than that in group C. The satisfaction rate of sedation / analgesia was significantly higher than that of group C (P 0.05). The incidence of body movement in group M was significantly lower than that in group C (P 0.05). There was no significant difference in the incidence of respiratory depression and respiratory obstruction between the two groups. Conclusion the bispectral index of EEG as a feedback control variable can control the depth of anesthesia accurately and can be safely used in the operation of chronic subdural hematoma in elderly patients.
【作者单位】：中国医科大学肿瘤医院辽宁省肿瘤医院麻醉科;沈阳军区总医院麻醉科;
【基金】：辽宁省自然科学基金(2013020194)
【分类号】：R614

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